- Question from Joyce: I am fearful of the amounts of radiation I receive from follow-up testing such as mammograms, bone density, bone scans, etc. Are there limits to what you can receive after radiation treatments? Also, should there be limits because of radiation received on airplane flights?
- Answers - Marisa Weiss, M.D. There are different kinds of radiation. Therapeutic radiation directed to the breast is high energy, extremely, precisely focused with very minimal scattering outside the treatment field. The kind of radiation that you experience with diagnostic tests, like mammograms (1/4 Rad is the exposure there), a bone scan, or a DEXA scan is very low energy. With current technology, there is very minimal radiation exposure here. The radiation you are exposed to in an airplane is even lower in energy and more diffuse. It is also tough to measure and depends on how long you are in flight and how high up you are. My general advice is to only get tests that you need that may help you and your doctor follow you over time to make the best treatment decisions. It's good to avoid unnecessary testing, but beyond that, I really would not worry about the additional radiation exposure.
- Gwen Darien A lot of women are concerned about potential cardiotoxicity—heart damage after radiation to the chest—after breast cancer treatment. I think the evidence is pretty inconclusive. Can you explain that?
Marisa Weiss, M.D.
Radiation is very scary stuff that we associate with natural and military disasters. With respect to the effects of radiation on the heart for women who are receiving therapeutic radiation to the left breast or chest wall area, there is a possibility that some of your heart may be in the treatment field. A very careful radiation oncologist who is meticulous and has 3-dimensional treatment planning available to him or her can do a very good job of maximizing the radiation to where it needs to go, while avoiding radiation exposure to the adjacent normal tissue like the heart. Most of the data that show a slight risk of heart damage from radiation therapy when given to the right breast area comes from old information when far less good technology was available. Today, we believe that, with very careful treatment planning by an expert in breast cancer radiation, the risk of heart damage should be completely avoidable.
It's also important to know that heart damage can occur from other forms of treatment including Adriamycin and chemotherapy, as well as Herceptin. And when some of these medications are combined together, there is the potential for more heart damage. Most doctors monitor your heart function throughout these types of chemotherapies.
The Ask-the-Expert Online Conference called Tackling Fear featured Lillie Shockney, R.N., B.S., M.A.S., Marisa Weiss, M.D. and moderator Gwen Darien, Editor-in-Chief, MAMM Magazine, answering your questions about how to manage breast cancer fears.
Editor's Note: This conference took place in June 2001.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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